Impact of antipsychotic treatment on nonfasting triglycerides in the CATIE Schizophrenia Trial phase 1

Schizophr Res. 2008 Aug;103(1-3):104-9. doi: 10.1016/j.schres.2008.04.023. Epub 2008 Jun 4.


Background: Recent literature documents a stronger association between nonfasting triglycerides (TG) and cardiovascular risk compared to fasting TG. Given concerns over antipsychotic effects on serum TG, this analysis explored changes in nonfasting TG in phase 1 of the CATIE Schizophrenia Trial.

Methods: Change in nonfasting TG, adjusted for baseline value, was compared between antipsychotic treatment groups using subjects with nonfasting laboratory assessments at baseline and 3 months.

Results: Among the 246 subjects there were significant treatment differences in 3-month change from baseline (p=0.009). The greatest increases in median and adjusted mean nonfasting TG levels were seen among those randomized to quetiapine (mean+54.7 mg/dl, median+26 mg/dl) and olanzapine (mean+23.4 mg/dl, median+26.5 mg/dl), while ziprasidone was neutral (mean+0.0 mg/dl, median+8 mg/dl), and decreases were seen with risperidone (mean -18.4 mg/dl, median -6.5 mg/dl) and perphenazine (mean -1.3 mg/dl, median -22 mg/dl). Pairwise comparisons indicated a significant between-group difference for perphenazine vs. olanzapine (p=0.002) and a trend for perphenazine vs. quetiapine (p=0.006).

Conclusions: This analysis provides further evidence for differential antipsychotic metabolic liabilities, and confirms signals for the effects of olanzapine and quetiapine on serum TG seen in earlier CATIE analyses. Future consensus recommendations will clarify the role of nonfasting TG monitoring in routine clinical practice.

Publication types

  • Clinical Trial, Phase I
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / therapeutic use
  • Benzodiazepines / adverse effects
  • Benzodiazepines / therapeutic use
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / chemically induced
  • Dibenzothiazepines / adverse effects
  • Dibenzothiazepines / therapeutic use
  • Female
  • Humans
  • Male
  • Middle Aged
  • Olanzapine
  • Perphenazine / adverse effects
  • Perphenazine / therapeutic use
  • Piperazines / adverse effects
  • Piperazines / therapeutic use
  • Quetiapine Fumarate
  • Risk Factors
  • Risperidone / adverse effects
  • Risperidone / therapeutic use
  • Schizophrenia / blood
  • Schizophrenia / drug therapy*
  • Thiazoles / adverse effects
  • Thiazoles / therapeutic use
  • Triglycerides / blood*


  • Antipsychotic Agents
  • Dibenzothiazepines
  • Piperazines
  • Thiazoles
  • Triglycerides
  • Benzodiazepines
  • Quetiapine Fumarate
  • ziprasidone
  • Perphenazine
  • Risperidone
  • Olanzapine